Hello, my Dr had me on Oxycodone 5/325 1-2 pills three times per day since 2005 and found I was still having pain issues(tolerance to them), so he changed my script to hydromorphone 2mg, can anyone tell me about this medication and is it stronger than the 5mg of oxy I was taking? I really do not like taking strong meds.

It's Dilaudid. and it's for short acting, BT pain relief. I have heard that it's only good in a hospital setting through an IV...but everyone is different...I think it's about the same but doesn't get absorbed as well as the Oxycodone...

The Following User Says Thank You to Rhonda_m_37 For This Useful Post:bunz50 (04-06-2011)

Hi Bunz. Because I am allergic to anything with oxycodone in it and drugs like hydrocodone don't work, all I use is hydromorphone. And according to my neurosurgeon, it is the best drug for spine pain(in his opinion). It works fast but does wear off fast but I do believe a long acting form has come on the market.

2mgs is the lowest does(I think) but it does help. I use 4mgs and wish they made a 3mgs pill(suppose I could cut a 6mg in half). It is strong and all I took after my first neck surgery. Switched to morphine for the second neck surgery and had a major reaction so I won't be takign it again.

But, hydromorphone makes me nauseous. It does go away with use though.

According to a chart I have of equivalency(how much of one drug equals the pain killing effect of another)7.5mgs of hydromorphone is equal to 30mgs of oxycodone, so doing some rough math, 2mgs of hydromorphone would be equal to about 8mgs of oxycodone.

They say it wears off quickly and you can take it every 4 hours but I have found it stays with you much longer and tapers slowly so you have a good chance to take more and keep yourself even in pain relief.

Hi Bunz. Because I am allergic to anything with oxycodone in it and drugs like hydrocodone don't work, all I use is hydromorphone. And according to my neurosurgeon, it is the best drug for spine pain(in his opinion). It works fast but does wear off fast but I do believe a long acting form has come on the market.

2mgs is the lowest does(I think) but it does help. I use 4mgs and wish they made a 3mgs pill(suppose I could cut a 6mg in half). It is strong and all I took after my first neck surgery. Switched to morphine for the second neck surgery and had a major reaction so I won't be takign it again.

But, hydromorphone makes me nauseous. It does go away with use though.

According to a chart I have of equivalency(how much of one drug equals the pain killing effect of another)7.5mgs of hydromorphone is equal to 30mgs of oxycodone, so doing some rough math, 2mgs of hydromorphone would be equal to about 8mgs of oxycodone.

They say it wears off quickly and you can take it every 4 hours but I have found it stays with you much longer and tapers slowly so you have a good chance to take more and keep yourself even in pain relief.

Good luck with it. It can upset your sleep so be careful at bedtime.

Jenny

Good Morning Jenny and thank-you, you are correct 2 mgs is the lowest and there is a long acting dose, it was one reason why my doc prescibed this med to me, stated if the 2mg worked for me (after 1 month)he would switch me to a long acting script. I finally took my first one last nite before bed(lol)and I do not sleep well in the first place(hey Jenny do you experience radiculopathy at night, I have in both arms and hands, keeps waking me, ugh) so I will take it earlier in the evening, I will have breakfast soon and will take my first one (for daytime)my Dr has 1 pill every 6 hrs(?) my oxy's = 1-2 every 4 hrs. I was on liquid morphine after my surgery due to swallowing issues had no problems, now is hydromorphone from the morphine family? Do they make you tired or that lazy feeling? Hoping these work for me and I can take less pills daily and keep my pain level under control.
Thanks again Jenny, ur the best, gotta love your brain and knowledge lol!
Bunz

Hi again Bunz......I take a muscle relaxer at bedtime instead. Has sleepy side effects and helps more with the radiculopathy than the pain meds do. If I need pain meds. I take them early in the day and then try to stop well before bedtime as they keep me up. The long acting type might help with that. I haven't tried it as I try really hard to avoid the narcotics(allergies). But you need to try it for few days and then try working with the doses to see what helps the most without interfering with sleep.

Isotope.....I've heard from more than a few docs that Dilaudid is the best drug for bone pain. Having used both morphine and Dilaudid after major spine surgery, I can truthfully say that the Dilaudid worked better. I also used it for the pain after double knee replacements. Maybe one of the reasons why I did so well after....I had really good pain relief and could do the rehab I needed. Was on it for 10 weeks and had absolutely no trouble getting off of it. Why it works well for orthopedic problems, I have no idea but it does. And I guess studies have agreed.

Good Morning Jenny and thank-you, you are correct 2 mgs is the lowest and there is a long acting dose, it was one reason why my doc prescibed this med to me, stated if the 2mg worked for me (after 1 month)he would switch me to a long acting script. I finally took my first one last nite before bed(lol)and I do not sleep well in the first place(hey Jenny do you experience radiculopathy at night, I have in both arms and hands, keeps waking me, ugh) so I will take it earlier in the evening, I will have breakfast soon and will take my first one (for daytime)my Dr has 1 pill every 6 hrs(?) my oxy's = 1-2 every 4 hrs. I was on liquid morphine after my surgery due to swallowing issues had no problems, now is hydromorphone from the morphine family? Do they make you tired or that lazy feeling? Hoping these work for me and I can take less pills daily and keep my pain level under control.
Thanks again Jenny, ur the best, gotta love your brain and knowledge lol!
Bunz

I have been taking hydromorphone (4mgs) since my surgery on 2/2/11. I have tried oxycodone, hydrocodone, lortab, and 1 or 2 others and they didn't work nearly as well "FOR ME" as dilaudid has. Granted the Dilaudid still does not get rid of all of the pain, but it takes enough away to generally make it 'bearable' most of the time. The others (esp percocets, even the strongest one) didn't even touch the pain. I have not had any problems with the dilaudid other than it makes me itch at times and I counteract that side effect with benadryl. Not sure why another poster would say it's not 'oral friendly' and I'm not really sure what they mean by that?? Thus far, it has offered me the best amount of relief. Generally it does not make me sleepy. I've found if I fall asleep shortly after taking a dose, it is more because it allowed me to relax (from the pain) enough to be able to fall asleep as I do NOT sleep well at all right now (hence look at the time I am posting here...lol)!! It sometimes gives me a little bit of a 'loopy' feeling but not too bad, and clearly not as bad as some of the others. I have noticed it does make me a little less verbally inhibited which can be funny at times!

My pharmacist said that the hydromorphone comes in 2mg, 4mg, and 8mg. I might have to ask my NS about the long acting one. Although I have always been told that the long acting narcotics are much more addictive than the short acting ones. So maybe I'll just stick with what they recommend since I don't want to deal with strong withdrawal symptoms one day when I am ready to discontinue use (although who knows when that will be??)

Interesting how what works for one doesn't work well for another...
I hope you find the best choice of pain relievers to offer you comfort as quickly as possible. Best of luck!

Dilaudid is an odd choice generally since Hydromorphone is so short acting and not very oral friendly. Exalgo would be the LA version, very spendy, mixed reviews.

Was Opana (Oxymorphone) mentioned? Might be a better choice, even the IR forms last 5+ hours.

Hello Isotope, I am not sure what you mean by user friendly? I assumed it was longer lasting than the oxycodone as it is 1 pill every 6 hrs max 3 a day and I was taking 6-8 oxy's per day.
Oxymorphone was not mentioned, here in Ontario Dr's are leary prescribing anything Oxy, per my Doc they are very addictive and he said there are a lot of people who abuse them, so he is cautious what he prescribes.
Bunz

Hi again Bunz......I take a muscle relaxer at bedtime instead. Has sleepy side effects and helps more with the radiculopathy than the pain meds do. If I need pain meds. I take them early in the day and then try to stop well before bedtime as they keep me up. The long acting type might help with that. I haven't tried it as I try really hard to avoid the narcotics(allergies). But you need to try it for few days and then try working with the doses to see what helps the most without interfering with sleep.

Isotope.....I've heard from more than a few docs that Dilaudid is the best drug for bone pain. Having used both morphine and Dilaudid after major spine surgery, I can truthfully say that the Dilaudid worked better. I also used it for the pain after double knee replacements. Maybe one of the reasons why I did so well after....I had really good pain relief and could do the rehab I needed. Was on it for 10 weeks and had absolutely no trouble getting off of it. Why it works well for orthopedic problems, I have no idea but it does. And I guess studies have agreed.

Keep me informed Bunz.

gentle hugs........Jenny

Hello Jenny, well they are definately working with little to no side effects, I do not take muscle relaxers, but I may make mention to my Dr, its nice not having to take so many pills! Taking 2-3 a day, I am up every morning at 5:00 am, hubby and I have our coffee, then I make him breakfast, pack his lunch and send him off to work(he is spoiled rotten lol,but so good to me) so I have my first pill around 6:00am, since sleep is a issue I have taken your advice and take them early in the day with my last one at 6:00pm. Will keep you posted
Bunz

I have been taking hydromorphone (4mgs) since my surgery on 2/2/11. I have tried oxycodone, hydrocodone, lortab, and 1 or 2 others and they didn't work nearly as well "FOR ME" as dilaudid has. Granted the Dilaudid still does not get rid of all of the pain, but it takes enough away to generally make it 'bearable' most of the time. The others (esp percocets, even the strongest one) didn't even touch the pain. I have not had any problems with the dilaudid other than it makes me itch at times and I counteract that side effect with benadryl. Not sure why another poster would say it's not 'oral friendly' and I'm not really sure what they mean by that?? Thus far, it has offered me the best amount of relief. Generally it does not make me sleepy. I've found if I fall asleep shortly after taking a dose, it is more because it allowed me to relax (from the pain) enough to be able to fall asleep as I do NOT sleep well at all right now (hence look at the time I am posting here...lol)!! It sometimes gives me a little bit of a 'loopy' feeling but not too bad, and clearly not as bad as some of the others. I have noticed it does make me a little less verbally inhibited which can be funny at times!

My pharmacist said that the hydromorphone comes in 2mg, 4mg, and 8mg. I might have to ask my NS about the long acting one. Although I have always been told that the long acting narcotics are much more addictive than the short acting ones. So maybe I'll just stick with what they recommend since I don't want to deal with strong withdrawal symptoms one day when I am ready to discontinue use (although who knows when that will be??)

Interesting how what works for one doesn't work well for another...
I hope you find the best choice of pain relievers to offer you comfort as quickly as possible. Best of luck!

Thank-you hausofmouse,

I hope you are doing well since your recent surgery (:!
So far the hydromorphone is very effective with really no side effects, yahoo! I understand the no sleep issue, although I force myself to stay in bed and at least rest my body, and I always try and nap later in the morning. So with the long-acting form is the dosage/mgs upped/stronger? Why would the longer acting type be more addicting? My Dr would not up my oxy's to 10's because they're addictive, and I now take 2-3 dilaudids compared to the 6-8 oxy's, are the dilaudids more addictive than oxys? I will be on meds most likely for the rest of my life, and worry about becoming immuned to different narcotics.
Thanks again
Bunz

Hope you got it all sorted out. I've been gone for a while, never saw the replies.

When I said that Hydromorphone wasn't "oral friendly", I meant that taking the drug orally (by mouth) was not the optimum administration route because the bioavailability is only 24% (PO) compared to 95% when administered Intravenously (IV).

The various Dose Calculators that Physicians use for conversions always factor all of these variables -so my point was somewhat irrelevant, oh yay!